Med-Surg UWORLD Actual Q-Bank Questions
& Definitive Solutions / Updated 2025/2026
During placement of an NG if the client begins to cough or gag because the tube may
have coiled in the throat or larynx what should the nurse do? - AnswerPull the tube
back slightly and allow the client to take a few deep breaths, after they do that ask the
client to take small sips of water to facilitate advancement to the stomach. If resistance
is met again rotate the tube while trying to advance it and if it still won't go in take it out
and try the other naris if possible
Nasoenteric tubes (goes into the jejunum) - Answer-used for administration of
continual or intermittent enteral feedings and medications
-If the tube is moved from the correct position and the length changes the nurse should
get an order from the doctor for a repeat x-ray before continuing a tube feeding or
administering medications
GCS - Answereye opening
verbal
motor
<8 we intubate
lowest is 3
highest is 15
what does the clients patient platelet count need to be before we avoid IM injections and
minimize venipuncture - Answerbelow 50,000 because those procedures can cause
prolonged bleeding
Hypothyroidism symptoms - AnswerBRADYCARDIA
WEIGHT GAIN, constipation
fatigue
lethargy, forgetfulness, and depression
oligo - or amenorrhea , infertility or decreased libido
COLD INTOLERANCE
anemia (pallor), dry skin
Ebola (viral hemorrhagic fever) - Answer-extremely contagious disease with a high
mortality rate
-these clients require contact, droplet and airborne precautions
-airborne isolation room with door closed
-visitors are prohibited unless absolutely necessary for the clients well being (mom sees
child)
-log everyone going in and out of the room
-procedures and use of sharps/needles are limited when possible
-NO medications or vaccines are approved for Ebola
,-Ebola you need 2 sets of gloves
Cystic fibrosis clients are on what type of diet - Answerhigh calorie
high protein
high fat
With anaphylactic reactions the nurse should look for which symptoms - Answer-
swelling of the mouth, tongue, lips and upper airway
-wheezing and difficulty breathing next
-lightheadedness due to hypotension, loss of consciousness and cardiovascular
collapse
-chest tightness
-Urticaria
Retinal detachment - Answer-curtains across the vision
-floaters or lightning flashes in the vision field
-Gnats/hairnet/cobwebs throughout the vision
(requires immediate treatment because if left untreated it results in blindness of the
affected eyes)
When is vomiting blood a concern? - Answerprojectile
bright red in color
ongoing
THROXICYTOSIS - AnswerBeta-adrenergic blockers (atenolol, metoprolol, and
propranolol) are used to relieve some of the symptoms of thyrotoxicosis (thyroid storm),
a complication of hyperthyroidism in which excessive thyroid hormones are released
into the circulation. Beta blockers block the effects of the sympathetic nervous system
and treat symptoms such as tachycardia, hypertension, irritability, tremors, and
nervousness in hyperthyroidism.
(Option 1) Atenolol is not iodine based. Iodine is used to treat thyrotoxicosis or to
prepare the client for a thyroidectomy. In large doses, iodine quickly blocks the release
of T4 and T3 from the gland within hours. In addition, iodine decreases thyroid gland
vascularity and is helpful when preparing the client for a thyroidectomy.
(Option 3) Atenolol does not contain radioactive iodine, the primary treatment for
hyperthyroidism. It damages or destroys the thyroid tissue, therefore limiting thyroid
secretion and eventually making the client hypothyroid.
(Option 4) Propylthiouracil and methimazole (Tapazole) are first-line antithyroid drugs
used to inhibit thyroid hormone synthesis.
Educational objective:
Beta-adrenergic blockers (atenolol, metoprolol, and propranolol) are given to relieve
some of the symptoms of thyrotoxicosis. They block the effects of the sympathetic
,nervous system and treat symptoms such as tachycardia, hypertension, irritability,
tremors, and nervousness in hyperthyroidism.
NMS - AnswerThis client is exhibiting signs and symptoms of neuroleptic malignant
syndrome (NMS), a rare but potentially life-threatening reaction. NMS is most often
seen with the "typical" antipsychotics (eg, haloperidol, fluphenazine). However, even the
newer "atypical" antipsychotic drugs (eg, clozapine, risperidone, olanzapine) can cause
the syndrome.\
NMS is characterized by fever, muscular rigidity, altered mental status, and autonomic
dysfunction (eg, sweating, hypertension, tachycardia). Treatment is supportive and is
directed at reducing fever and muscle rigidity and preventing complications. Treatment
in an intensive care unit (ICU) may be required. The most important intervention is to
immediately discontinue the antipsychotic medication and notify the HCP for further
assessment
Educational objective:
NMS is characterized by fever, muscle rigidity, altered mental status, and autonomic
dysfunction. The most important intervention is to discontinue the antipsychotic
medication
Parts of the brain - AnswerParietal lobe: sensory
Frontal: behavioral. memory and voluntary movement
temporal: auditory changes
occipital: vision changes
A serial neurologic assessment includes: (blunt head injury) - Answer1. Glasgow
Coma Scale (GCS)—best eye, verbal, and motor responses. Best verbal response
assesses orientation to person, place, and time (time is the most sensitive). (if GCS
drops down 1 number in an hour that is significant)
2. Pupils—equal, round, response to light, and accommodate (PERRLA)
3. Motor—strength and movement in all four extremities
4. Vital signs—especially any signs of Cushing's triad of bradycardia,
bradypnea/abnormal breathing pattern and widening pulse pressure (the difference
between systolic and diastolic blood pressure readings). The nurse is assessing for
signs of increased intracranial pressure (ICP).
one of the earliest signs of increased ICP is: CHANGE IN LOC
A neuromuscular assessment consist of: - Answer5 Ps
Pain
Pallor
Paresthesia
, Paralysis
Pulselessness
When circulation is a primary concern
(compartment syndrome, people with casts)
With a lumbar puncture the CSF is assessed for - Answercolor
contents
pressure
Normal Csf: clear, colorless, contains a little protein, title glucose, minimal white blood
cells, NO red blood cells and no organisms
Normal CSF pressure is 60 -1 50 (if pressure is abnormal may be the reason for
headaches)
lumbar puncture procedure - AnswerBEFORE:
1. Empty the bladder
2. Can be placed in LATERAL RECUMBENT (fetal) or SITTING UPRIGHT
3. sterile needle inserted between l3 - l5 (lower part of spine)
4. pain may be felt radiating down the leg temporarily
AFTER:
1. Lie flat NO PILLOW for at least 4 hours to reduce leaks of CSF
2. Increase fluid intake for at least 24 hours after to prevent dehydration
Mannitol - Answer-An osmotic diuretic used to treat cerebral edema and acute
glaucoma.
-Normal kidney function and adequate urine output are crucial while administering this
medication as mannitol accumulation can result in significant volume expansion,
dilutional hyponatremia, and pulmonary edema.
(crackles is the most sensitive indicator of fluid overload not pitting edema in the tibia)
Spinal immobilization - AnswerN - Neurological examination. Focal deficits include
numbness and decreased strength.
S - Significant traumatic mechanism of injury
A - Alertness. The client may be disoriented or have an altered level of consciousness
(Option 2).
I - Intoxication. The client could have impaired decision-making ability or lack
awareness of pain (Option 1).
D - Distracting injury. Another significant injury could distract the client from spinal pain.
S - Spinal examination. Point tenderness over the spine or neck pain on movement (if
there is no midline tenderness) may be present
& Definitive Solutions / Updated 2025/2026
During placement of an NG if the client begins to cough or gag because the tube may
have coiled in the throat or larynx what should the nurse do? - AnswerPull the tube
back slightly and allow the client to take a few deep breaths, after they do that ask the
client to take small sips of water to facilitate advancement to the stomach. If resistance
is met again rotate the tube while trying to advance it and if it still won't go in take it out
and try the other naris if possible
Nasoenteric tubes (goes into the jejunum) - Answer-used for administration of
continual or intermittent enteral feedings and medications
-If the tube is moved from the correct position and the length changes the nurse should
get an order from the doctor for a repeat x-ray before continuing a tube feeding or
administering medications
GCS - Answereye opening
verbal
motor
<8 we intubate
lowest is 3
highest is 15
what does the clients patient platelet count need to be before we avoid IM injections and
minimize venipuncture - Answerbelow 50,000 because those procedures can cause
prolonged bleeding
Hypothyroidism symptoms - AnswerBRADYCARDIA
WEIGHT GAIN, constipation
fatigue
lethargy, forgetfulness, and depression
oligo - or amenorrhea , infertility or decreased libido
COLD INTOLERANCE
anemia (pallor), dry skin
Ebola (viral hemorrhagic fever) - Answer-extremely contagious disease with a high
mortality rate
-these clients require contact, droplet and airborne precautions
-airborne isolation room with door closed
-visitors are prohibited unless absolutely necessary for the clients well being (mom sees
child)
-log everyone going in and out of the room
-procedures and use of sharps/needles are limited when possible
-NO medications or vaccines are approved for Ebola
,-Ebola you need 2 sets of gloves
Cystic fibrosis clients are on what type of diet - Answerhigh calorie
high protein
high fat
With anaphylactic reactions the nurse should look for which symptoms - Answer-
swelling of the mouth, tongue, lips and upper airway
-wheezing and difficulty breathing next
-lightheadedness due to hypotension, loss of consciousness and cardiovascular
collapse
-chest tightness
-Urticaria
Retinal detachment - Answer-curtains across the vision
-floaters or lightning flashes in the vision field
-Gnats/hairnet/cobwebs throughout the vision
(requires immediate treatment because if left untreated it results in blindness of the
affected eyes)
When is vomiting blood a concern? - Answerprojectile
bright red in color
ongoing
THROXICYTOSIS - AnswerBeta-adrenergic blockers (atenolol, metoprolol, and
propranolol) are used to relieve some of the symptoms of thyrotoxicosis (thyroid storm),
a complication of hyperthyroidism in which excessive thyroid hormones are released
into the circulation. Beta blockers block the effects of the sympathetic nervous system
and treat symptoms such as tachycardia, hypertension, irritability, tremors, and
nervousness in hyperthyroidism.
(Option 1) Atenolol is not iodine based. Iodine is used to treat thyrotoxicosis or to
prepare the client for a thyroidectomy. In large doses, iodine quickly blocks the release
of T4 and T3 from the gland within hours. In addition, iodine decreases thyroid gland
vascularity and is helpful when preparing the client for a thyroidectomy.
(Option 3) Atenolol does not contain radioactive iodine, the primary treatment for
hyperthyroidism. It damages or destroys the thyroid tissue, therefore limiting thyroid
secretion and eventually making the client hypothyroid.
(Option 4) Propylthiouracil and methimazole (Tapazole) are first-line antithyroid drugs
used to inhibit thyroid hormone synthesis.
Educational objective:
Beta-adrenergic blockers (atenolol, metoprolol, and propranolol) are given to relieve
some of the symptoms of thyrotoxicosis. They block the effects of the sympathetic
,nervous system and treat symptoms such as tachycardia, hypertension, irritability,
tremors, and nervousness in hyperthyroidism.
NMS - AnswerThis client is exhibiting signs and symptoms of neuroleptic malignant
syndrome (NMS), a rare but potentially life-threatening reaction. NMS is most often
seen with the "typical" antipsychotics (eg, haloperidol, fluphenazine). However, even the
newer "atypical" antipsychotic drugs (eg, clozapine, risperidone, olanzapine) can cause
the syndrome.\
NMS is characterized by fever, muscular rigidity, altered mental status, and autonomic
dysfunction (eg, sweating, hypertension, tachycardia). Treatment is supportive and is
directed at reducing fever and muscle rigidity and preventing complications. Treatment
in an intensive care unit (ICU) may be required. The most important intervention is to
immediately discontinue the antipsychotic medication and notify the HCP for further
assessment
Educational objective:
NMS is characterized by fever, muscle rigidity, altered mental status, and autonomic
dysfunction. The most important intervention is to discontinue the antipsychotic
medication
Parts of the brain - AnswerParietal lobe: sensory
Frontal: behavioral. memory and voluntary movement
temporal: auditory changes
occipital: vision changes
A serial neurologic assessment includes: (blunt head injury) - Answer1. Glasgow
Coma Scale (GCS)—best eye, verbal, and motor responses. Best verbal response
assesses orientation to person, place, and time (time is the most sensitive). (if GCS
drops down 1 number in an hour that is significant)
2. Pupils—equal, round, response to light, and accommodate (PERRLA)
3. Motor—strength and movement in all four extremities
4. Vital signs—especially any signs of Cushing's triad of bradycardia,
bradypnea/abnormal breathing pattern and widening pulse pressure (the difference
between systolic and diastolic blood pressure readings). The nurse is assessing for
signs of increased intracranial pressure (ICP).
one of the earliest signs of increased ICP is: CHANGE IN LOC
A neuromuscular assessment consist of: - Answer5 Ps
Pain
Pallor
Paresthesia
, Paralysis
Pulselessness
When circulation is a primary concern
(compartment syndrome, people with casts)
With a lumbar puncture the CSF is assessed for - Answercolor
contents
pressure
Normal Csf: clear, colorless, contains a little protein, title glucose, minimal white blood
cells, NO red blood cells and no organisms
Normal CSF pressure is 60 -1 50 (if pressure is abnormal may be the reason for
headaches)
lumbar puncture procedure - AnswerBEFORE:
1. Empty the bladder
2. Can be placed in LATERAL RECUMBENT (fetal) or SITTING UPRIGHT
3. sterile needle inserted between l3 - l5 (lower part of spine)
4. pain may be felt radiating down the leg temporarily
AFTER:
1. Lie flat NO PILLOW for at least 4 hours to reduce leaks of CSF
2. Increase fluid intake for at least 24 hours after to prevent dehydration
Mannitol - Answer-An osmotic diuretic used to treat cerebral edema and acute
glaucoma.
-Normal kidney function and adequate urine output are crucial while administering this
medication as mannitol accumulation can result in significant volume expansion,
dilutional hyponatremia, and pulmonary edema.
(crackles is the most sensitive indicator of fluid overload not pitting edema in the tibia)
Spinal immobilization - AnswerN - Neurological examination. Focal deficits include
numbness and decreased strength.
S - Significant traumatic mechanism of injury
A - Alertness. The client may be disoriented or have an altered level of consciousness
(Option 2).
I - Intoxication. The client could have impaired decision-making ability or lack
awareness of pain (Option 1).
D - Distracting injury. Another significant injury could distract the client from spinal pain.
S - Spinal examination. Point tenderness over the spine or neck pain on movement (if
there is no midline tenderness) may be present
